What is it about?

This study explores how dreams can be used within cognitive-behavioral therapy (CBT), particularly with patients who find it difficult to identify or describe their emotions, beliefs, and inner experiences. Through three clinical cases, we show how a structured approach to dream exploration can help bring important emotional themes and core beliefs into focus, support case formulation, and enrich the therapeutic process without relying on symbolic interpretation.

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Why is it important?

Dreams are often discussed in psychotherapy, yet they are still rarely integrated into CBT in a structured way. This study shows that dream material may offer a useful route to emotions, core beliefs, and personal meanings that can be difficult to access through verbal techniques alone. It also illustrates how dream work can be incorporated into CBT without relying on symbolic interpretation.

Perspectives

This work began with a simple question that often arises in the therapy room: when a patient brings a dream into session, what can we make of it? We wanted to explore whether dreams could find a place within CBT without losing their emotional richness and without being confined to symbolic interpretation. Dreams may be understood as spontaneously generated experiential simulations - vivid, emotionally charged images in which fears, beliefs, relationships, and personal concerns can take form. From this perspective, dream work can be seen as naturally connected to the growing role of imagery and experiential techniques in contemporary cognitive therapy. For us, this study represents a first step toward bringing dreams back into the therapy room: not as messages to be decoded, but as living experiences that therapist and patient can explore together to better understand the patient’s inner world.

Fabrizia Tudisco
School of Cognitive Psychotherapy SPC - Naples

Read the Original

This page is a summary of: Clinical applications of dream work in cognitive therapy: Evidence from the literature and case discussions., Dreaming, September 2026, American Psychological Association (APA),
DOI: 10.1037/drm0000356.
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